Effect Of A CCR5 Coreceptor Antagonist On The Latency And Reservoir Of HIV-1 - Full Text View

Sponsors and Collaborators:	Fundacion para la Investigacion Biomedica del Hospital Universitario Ramon y Cajal Academic grant from Pfizer Inc.
Information provided by:	Fundacion para la Investigacion Biomedica del Hospital Universitario Ramon y Cajal
ClinicalTrials.gov Identifier:	NCT00795444

Purpose

The presence of a pool of cells latently infected by HIV-1 in patients taking HAART and with a viral load below 50 copies/mL is the main limitation to eradication of the virus from the body. This viral reservoir prevents antiretroviral therapy from being interrupted; therefore, patients are obliged to continue with treatment for a period calculated to be greater than 60 years.

Despite the important advances in knowledge of the biology of this reservoir, we still have no real knowledge about its dynamics. The opportunity to carry out a clinical trial for the first time with CCR5 coreceptor antagonists is exceptional, since the results could provide important information on the nature of this reservoir.

If maintenance of the reservoir is a dynamic process, inclusion of CCR5 inhibitors is expected to lead to a reduction in the size of this reservoir. This effect could be critical when including IAT (viral reactivation), since, in theory, it would be necessary to act on a smaller reservoir. Current consensus is that it would be necessary to act on almost 100% of the viral reservoir (approximately 1,000,000 cells).

The study has also been designed to enable us to understand the biochemical and molecular mechanisms by which certain drugs can induce viral reactivation in vitro as a previous step to a clinical trial aimed at reactivating viral latency and eradicating HIV-1 from the body.

Condition	Intervention	Phase
HIV-1	Drug: maraviroc	Phase II

MedlinePlus related topics: AIDS

Drug Information available for: Maraviroc

U.S. FDA Resources

Study Type:	Interventional
Study Design:	Basic Science, Open Label, Single Group Assignment, Efficacy Study
Official Title:	Pilot Study Of The Effect Of A CCR5 Coreceptor Antagonist On The Latency And Reservoir Of HIV-1 In Patients Taking Highly Active Antiretroviral Therapy

Further study details as provided by Fundacion para la Investigacion Biomedica del Hospital Universitario Ramon y Cajal:

Primary Outcome Measures:

Frequency of resting CD4+ T cells infected by a replicative virus [ Time Frame: 12 months ] [ Designated as safety issue: No ]

Estimated Enrollment:	10
Study Start Date:	March 2008

Arms	Assigned Interventions
Maraviroc: Experimental Adult patients with HIV infection and a viral load that has been suppressed for a long period (less than 50 copies/mL for at least 2 years) while on antiretroviral therapy.The treatment group will maintain the habitual antiretroviral therapy combined with maraviroc.	Drug: maraviroc Maraviroc (INN), 300 mg tablets. A dose of 300 mg will be administered every 12 hours.

Eligibility

Ages Eligible for Study:	18 Years and older
Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

After receiving information on the design and objectives of the study, the possible risks involved, and the fact that they can refuse to collaborate at any time, patients will give their informed consent to participate in the study and agree to provide material for the cellular and molecular studies.
Aged over 18 years.
Chronic HIV infection
Antiretroviral therapy with at least 3 drugs for at least 2 years and with no modifications expected during the study. Antiretroviral drugs can be switched due to intolerance as long as plasma viremia remains controlled.
Undetectable viral load determined by ultrasensitive techniques (<50 copies HIV RNA/mL) for at least 2 years.
CD4+ T lymphocyte count above 350 cells/mm3.
Demonstration of R5 viral tropism (use of CCR5 coreceptors) by phenotyping in plasma samples stored before antiretroviral therapy is started.
Understand the objective of the study and be available to make frequent visits to the hospital.

Exclusion Criteria:

Previous failure of antiretroviral therapy, understood as a rebound in viral load that can be detected after having reached undetectable levels. Low-grade increases (<200 copies of HIV RNA/mL) and transitory increases (blips) resolved without modifying antiretroviral therapy are excluded.
Proven resistance against the antiretroviral drugs under study.
Planned interruption of antiretroviral therapy.
Taking immunosuppressive or immunostimulating medication of any type, including valproic acid.
Taking a fusion inhibitor (enfuvirtide).
Pregnancy or intention to become pregnant during the study.

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00795444

Contacts

Contact: Santiago Moreno Guillen, MD,PhD

+34 913368710

smoreno.hrc@salud.madrid.org

Locations

Spain
Hospital Universitario Ramon Y Cajal	Recruiting
MADRID, Spain, 28034
Contact: Santiago Moreno Guillen, MD,PhD +34 91 336 87 10 smoreno.hrc@salud.madrid.org
Principal Investigator: Santiago Moreno Guillén, MD,PhD
Sub-Investigator: Jose Luis Casado Osorio, MD
Sub-Investigator: Fernando Dronda Nuñez, MD,PhD
Sub-Investigator: Ana Moreno Zamora, MD,PhD
Sub-Investigator: Maria Jesús Pérez Elias, MD,PhD
Sub-Investigator: Beatriz Hernández Novoa, PharmD,PhD
Sub-Investigator: Carolina Gutierrez Montero, PhD
Sub-Investigator: Rafael Rubio Garcia, MD,PhD

Sponsors and Collaborators

Fundacion para la Investigacion Biomedica del Hospital Universitario Ramon y Cajal

Academic grant from Pfizer Inc.

Investigators

Principal Investigator:

Santiago Moreno Guillen, MD,PhD

HOSPITAL UNIVERSITARIO RAMON Y CAJAL. MADRID

More Information

Responsible Party:	( Fundacion para la Investigacion Biomedica del Hospital Universitario Ramon y Cajal (Santiago Moreno Guillen) )
Study ID Numbers:	ERRADVIH-01, Eudra CT 2007-003995-21
Study First Received:	November 10, 2008
Last Updated:	December 16, 2008
ClinicalTrials.gov Identifier:	NCT00795444
Health Authority:	Spain: Spanish Agency of Medicines

Keywords provided by Fundacion para la Investigacion Biomedica del Hospital Universitario Ramon y Cajal:

HIV-1
CCR5 coreceptor antagonist (Maraviroc)
the cell reservoir of HIV-1

Study placed in the following topic categories:

HIV Infections
Acquired Immunodeficiency Syndrome

ClinicalTrials.gov processed this record on January 14, 2009